肝移植术后患者血清Leptin浓度变化及其意义

The Changes and Significance of Serum Leptin Levels in Patients Post-liver Transplantation

探讨肝移植造成的肝缺血/再灌注损伤对血清Leptin水平的影响。收集切除全肝的恶性原发性肝癌和胆管癌患者血清,采用RIA和ELISA测定血清Leptin、C反应蛋白(CRP)和白细胞介素1β(IL1β)水平的变化。结果表明,与术前自身对照相比,术后即刻Leptin水平下降,经无肝期1h继续降低,新肝期1h达最低点,术后10h即恢复并高于术前(P<0.05)。CRP水平也呈相似变化,在新肝期1h达最低点,以后逐渐恢复至正常水平。血清IL1β水平也是先有降低趋势,术后10h恢复至正常。这提示肝移植后患者血清Leptin水平先降后升,与术前相比有显著性差异,伴有急性期CRP和IL1β的变化,说明Leptin在肝移植过程中发挥着重要作用。

To explore the effect of liver transplantation-induced liver ischemia/reperfusion injury on serum leptin levels in these patients, serum samples of patients with malignant primary liver cancer or cholangiocarcinoma who had been given holo-hepatectomy were collected, and RIA and ELISA were used to detect serum levels of leptin, CRP and Interleukin-ll3 （IL-113） in these patients. Results showed that compared with self-control before operation, leptin level de- creased immediately after operation, continued to decrease after one hour of non-liver period, reached the lowest level after one hour of neo-liver period, and increased to a higher level than that of self-control before operation at ten hours after operation （P^0.05）. Serum level of CRP had a similar change as that of leptin, reaching the lowest after one hour of neo-liver peri- od and recovering to normal level gradually after that. Serum level of IL-113 also expressed a trend to decrease at the beginning and to recover to normal level at 10 hours after operation. Results showed that serum leptin level decreased significantly in the early stage of post-liver transplantation and increased thereafter with a significant difference vs that before operation, which occurred concurrently with the changes of acute phase protein CRP and inflammatory cytokine IL-1β, which indicates that leptin plays an important role in liver transplantation.